Hip Bursitis: Causes, Symptoms, Treatment, and Exercises

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Hip BursitisDo you experience pain in the hip area when lying down on one side? Or perhaps you have a dull ache in the upper buttocks after sitting for a prolonged time? You may be suffering from hip bursitis, a serious condition that, if left untreated, can lead to complications of reduced mobility and progressive pain. We will discover hip bursitis causes and learn the best hip bursitis exercises to help alleviate symptoms.

Bursitis refers to the inflammation of the tiny, fluid-filled sacs that cushion the muscles, tendons, and bones. These sacs, known as bursae, protect and lubricate to avoid damage from friction movement.

We have two bursae in our hips: the trochanteric and the ischial. The trochanteric bursa is on the side of our hip and causes a dull, burning sensation when inflamed. It can be difficult to lie on the affected side, and exercise or walking may cause severe pain. The ischial bursa is found in the upper buttock region, which is why you may have a dull pain after sitting or excessive climbing with bursitis.

An uncommon related condition is septic hip bursitis. This presents similar symptoms as well as fever, exhaustion, and a warm, red swelling of the hip region. This is a serious state that demands immediate medical attention.

What Are the Types of Hip Bursitis?

Bursitis cases are categorized based on the region of the body and the exact bursa affected. The hip has two major bursae—the trochanteric bursa and ischial bursa. Appropriately, the types of hip bursitis, or bursitis of the hip, are named after these two:

1. Trochanteric Bursitis

If you have ever looked at a femur, you will notice a sort of “hump” near the ball-like part that connects to the pelvis. This hump is the greater trochanter and the trochanteric bursa lies next to it. Trochanteric bursitis is when this bursa gets inflamed. The symptoms of trochanteric bursitis are more likely to feel one-sided and can be provoked by activities involving lifting motions with the legs, such as walking up the stairs or getting out of a car.

2. Ischial Bursitis

The ischial bursa lies between the ischial tuberosity and the hamstring. The ischial tuberosity is easily identified since, when standing, it’s covered by the gluteus maximus. A less medically precise explanation is that the ischial tuberosity is your “butt bone.” Ischial bursitis, due to its location, produces symptoms that can be initially mistaken for a pulled hamstring or are otherwise connected to sitting or standing.

What Causes Hip Bursitis?

Hip bursitis is usually caused by repetitive motion or prolonged stance in one positon. Let’s take a closer look at these and other hip bursitis causes that attribute to this painful condition.

1. Repetitive Pressure

Consistent movement or holding the hip in one position for extended time periods can cause bursitis. This strain on the bursa may be present with bouts of prolonged sitting, standing, or repetitive activity of the hip region such as with cycling and jogging.

2. Injury

Traumatic bursitis is a condition occurring from a hard fall or hit to the hip. The result is blood filling the lining of the bursa and the sac itself. Inflammation is present and remains after the blood is absorbed by the body.

3. Other Health Conditions

As bursitis is characterized by inflammation of the bursa lining, or synovial membrane, several related health conditions can trigger hip bursitis. This membrane is directly affected by rheumatoid arthritis and the synovial joints are affected by gout.

4. Physical Condition

Our body depends on the proper function of the skeletal and musculature systems, and when something breaks down or is disturbed, it can cause hip bursitis. This can be present with a deformity of the lower limbs, spinal issues, and joint conditions.

5. Surgery History

If you have undergone a surgical procedure involving the hips or any of the adjoining regions, hip bursitis can develop.

6. Bone Spurs or Calcium Deposits

Hip bursitis can be caused by the presence of bone spurs or calcium deposits. The spurs occur in the joints, while calcium can build up in the tendons.

7. Repeat Inflammation

Once you have bursitis, you are at a high risk of getting it again.

8. Gender and Age

Women are reportedly more likely to develop hip bursitis than men. This condition also seems to be more prevalent in those older than 40 years of age.

Symptoms of Hip Bursitis

Hip bursitis symptoms may vary from patient to patient and depend on the health condition of the person and the cause of the bursitis. See if any of the following signs or symptoms relate to your experience.

1. Pain

The most common symptom is pain. The initial stage may give a sharp, stabbing sensation that develops into a constant ache. The pain may be worse when lying on the affected side, during prolonged sitting, or after repetitive movement of the area.

2. Radiating Pain

The pain of hip bursitis may present on the outer region of the hip before radiating along the outer thigh, lower back, groin or buttocks regions.

3. Tenderness

The hip may become tender to the touch or when pressure is applied.

4. Range of Motion

You may lose some range of motion due to the excruciating pain felt when moving the leg.

Bursitis causes pain, stiffness, and inflammation within the affected area along with stiffness or an aching sensation. The main difference between bursitis types is where this pain will be located and what can worsen it. Additionally, there may be an angry redness around the joint in question.

With trochanteric bursitis:

  • Pain will be localized on the outer hip, thigh, or within the buttock.
  • Pain will manifest when lying down on the relevant side or when you press in on the side of the hip.
  • Pain will worsen, as mentioned above, by activities like getting out of the car, walking up stairs, or anything that induces similar leg and hip motions.

With ischial bursitis:

  • Pain will appear in the upper buttock or hamstring area.
  • Pain may be more noticeable when trying to climb uphill or after prolonged sitting on a hard surface.
  • Stretching the hamstring may also aggravate the pain.

How to Treat Hip Bursitis

Many people rely on the use of over-the-counter pain relievers to combat the inflammation and pain sensations of hip bursitis. Other medical treatments include:

1. Aspiration

A needle can be used to drain the bursa in extreme inflammation cases.

2. Corticosteroids

Injections may be necessary to relieve symptoms with the assistance of ultrasound imaging.

3. Antibiotics

For infections such as septic hip bursitis, an antibiotic treatment may be prescribed by a health professional. Severe cases involve hospitalization.

4. Surgery

Certain factors causing the hip bursitis may require surgery. This can include a bursectomy (removal of the bursa), a tendon repair and iliotibial release procedure, or an osteotomy (surgical cutting) of the greater trochanter bone.

5. Physical Therapy  

Hip bursitis physical therapy may be part of your doctor’s treatment plan. Specific exercises can help to ease pain, strengthen muscles, and prevent complications.

Are There Any Natural Remedies for Hip Bursitis?

Natural hip bursitis treatments take steps to comfort the joint, minimize strain, and ease inflammation.

1. Rest and Immobilization

Hip bursitis affects joints related to walking and standing, so resting them means a good deal of lying down. However, since hip bursitis can be aggravated by prolonged contact with a solid surface, you may need to get creative. Try to lie down on your stomach or make sure you are sitting on a cushion or mattress. When moving, especially if getting up or sitting down, take care not to place pressure on the bursa in question—this may require assistance or at least something else to support your weight (an armrest or a banister, for example).

2. Ice

Cold temperatures can help reduce the swelling. Make sure to never put the ice directly on your skin. Wrapping ice cubes in a cloth or thin towel should be enough to protect yourself while still letting the cold do its work.

3. Heat

If the swelling has gone down but the joint is still giving you trouble, a hot compress may be able to soothe it or at least help take your mind off the bursitis. Getting heat therapy is as simple as filing a hot water bottle to your personal preferred temperature and getting comfortable. You can also alternate between hot and cold.

4. Support

It’s important to keep weight off the affected bursa while recovering. For trochanter bursitis, this means you may need a walking stick or crutches for a week or so while the inflammation dies down.

5. Exercise and Stretches

As a form of physiotherapy, you can try certain stretches and exercises that work on the area around the bursa and can help restore mobility in the face of hip bursitis. Your doctor may be able to recommend some, but you can also check the section below.

Hip Bursitis Exercises

While rest and immobilization is important to combating symptoms of hip bursitis, it is equally crucial to maintain movement of the region. This can be safely done with several hip bursitis stretching and weight reduction exercises you can do at home four to five times each week.

1. Hip Bridges

Strengthen your hip by working the hamstrings, lower back, glutes, quadriceps, and hip flexors. Lie on your back on the floor with knees bent and feet placed flat on the floor near the buttocks. Raise your hips to knee height by pushing your weight toward the heels. Lower the hips and repeat 20 times for five sets.

2. Lateral Leg Raises

Strengthen the iliotibial band across the outer region of the hip with this targeted leg exercise. Lie on your right side on the floor and balance yourself by extending your right arm. Lift the left leg as far as you are able comfortably, and then lower it back to starting position. Repeat on the other side. Do four sets 15 times. This exercise targets the hamstrings, obliques, quadriceps, gluteus maximus, and gluteus minimus muscles.

3. Leg Circles

Improve your leg and hip strength, range of motion, and flexibility with leg circles. Target the hip flexors and gluteal muscles. Lie on your back on the floor and lift one leg about three inches high to make a circular motion—keep your leg straight. Repeat on the other leg. Do five times on each leg for three sets.

4. Abductor Stretch

The abductors are the muscles that run along the outer thigh from the hip joints. Begin this exercise for hip bursitis in a standing position, then cross the unaffected leg in front of the affected one and begin leaning away from the bursitic side of your body. Continue leaning until you feel a stretch along the outer hip, then hold and release.

5. Adductor Stretch

The adductor muscles are in the same area as the abductors but are responsible for inward leg motions. Begin this stretch in a standing position with your legs more than shoulder-width apart. Slowly bend the non-bursitic knee out to the side until you feel a stretch on the inner thigh of the bursitic side. Hold, then release.

6. Rotator Stretch

This targets the muscles that help rotate the leg at the hip. Begin in a sitting position and rest the ankle of the bursitic-side foot on the thigh of the non-bursitic leg. Gently press down on the knee of the bursitic side until you feel a stretch in your buttocks.

7. Flexor Stretch

The flexors are the muscles that help raise the leg towards the front of your body. Begin in a standing position and bend the knee of the bursitic side so that your heel is being brought towards the buttocks. Continue until you can grab your ankle with your hand, then hold and release. Note: you do not necessarily have to be standing to perform this stretch; it can also be done on your side or stomach.

What Is the Average Recovery Time for Hip Bursitis?

It takes about six weeks to fully recover from a case of hip bursitis. Fortunately, your activities will only see major restrictions during the initial period when the symptoms are at their worst. Once the symptoms die down, you can carefully increase the amount of activity you undertake so long as you avoid movements that will aggravate the bursitis.

What Are the Risk Factors for Developing Hip Bursitis? Who Is at Risk of Hip Bursitis?

1. Age

Like arthritis and similar joint conditions, bursitis becomes more likely the older you are.

2. Repetitive motions

Any occupation or hobby that involves repetitive motions or repeatedly sitting down and getting up (setting tile, laying carpet, etc.) puts you at a higher risk for developing bursitis.

3. Diseases

Certain systemic conditions such as rheumatoid arthritis, gout, or diabetes can also increase the risk.

4. Weight

Being overweight increases pressure on the joints.

How to Prevent Bursitis of the Hip

  • Try not to sit in one position for too long, particularly on hard surfaces.
  • Use some of the above hip bursitis exercises to strengthen the joints around the hips.
  • Warm up and stretch before any strenuous activity.
  • Maintain a healthy weight.
  • When lifting large or heavy objects, make sure to bend at your knees to avoid putting unnecessary stress on the hip’s bursae.

When Should You Seek Medical Help?

A doctor’s visit is always helpful when you want to be certain of the diagnosis, but most cases of bursitis of the hip will resolve without medical attention. There are certain conditions, however, where you should definitely arrange to speak to your medical provider, such as:

  • You experience repeated cases of bursitis;
  • The affected area appears red and feels warm;
  • You have a fever;
  • The pain doesn’t improve despite treatment measures; and
  • The pain is enough that it interferes with day-to-day activity.

Hip bursitis can be a debilitating disorder that may disrupt your daily activities, including the ability to work. Whether it is caused by an existing health condition, injury, or repetitive movement or stance, bursitis should not be overlooked and requires attention. Hip bursitis treatment can include medical procedures and therapy and may also be addressed by natural remedies. Your body runs on a delicate system that needs tender loving care every once in a while.

Also Read:

Shiel, W., “Hip Bursitis,” Medicine Net; http://www.medicinenet.com/hip_bursitis/article.htm, last accessed April 5, 2017.
“Bursitis,” Mayo Clinic; http://www.mayoclinic.org/diseases-conditions/bursitis/basics/definition/con-20015102, last accessed April 5, 2017.
“Bursitis,” Web MD; http://www.webmd.com/pain-management/arthritis-bursitis#1, last accessed April 5, 2017.
Funiciello, M., “Hip (Trochanteric) Bursitis,” Arthritis Health, April 30, 2012; http://www.arthritis-health.com/types/bursitis/hip-trochanteric-bursitis, last accessed April 5, 2017.
Salyer, J., “The Essential Exercises to Relieve Hip Bursitis Pain,” Healthline; http://www.healthline.com/health/fitness-exercise/hip-bursitis-exercises#2, last accessed April 5, 2017.